Propofol reduces tissue-Doppler markers of left ventricle function: a transthoracic echocardiographic study

BACKGROUND: Propofol is thought to minimally depress myocardial function,but mainly to reduce blood pressure by vasodilation. Transthoracictissue-Doppler echocardiography (TDE) is a novel, validatedmethod of quantifying myocardial function. It provides new insightinto myocardial function by measuring myocardial motion. Weexamined the effects of propofol upon myocardial function bymeasuring changes in left ventricle function by TDE. METHODS: We assessed change in myocardial function in propofol anaesthetizedASA I patients tissue tracking displacement (TTD) before anaesthesiaonset and repeated measurements after a single propofol bolusdose. Tissue tracking score (TTS), a marker of ejection fraction,was also used (n = 10). RESULTS: Propofol 1.5–2 mg kg^–1 significantly attenuatedPSV from 5.64 (1.17) to 4.66 (0.55) cm s^–1 (P< 0.0001) and TTD from 10.2 (2.1) to 8.5 (1.4) mm (P= 0.0091), whereas TTP was unchanged [all data: mean (SD)].TTS declined from 7.2 (1.3) to 6.1 (0.6) mm (P < 0.01).Non-invasive mean blood pressure declined 17% (P < 0.0001). CONCLUSIONS: The results indicate that myocardial contractile function iscompromised concomitantly with reduced cyclic displacement afterpropofol dosing. Blood pressure declined accordingly. From theseresults, it is impossible to ascertain whether this was secondaryto reduced cardiac filling or a consequence of a direct negativeinotropic action of propofol, but it represents a left-shiftof the Starling curve. The novel TDE yields new informationon myocardial velocities and motion.